The most common complication of a lumbar puncture is a mild headache, usually the next day, although this is by no means universal. (6) a very rare late manifestation, often years afterwards, of benign swelling and tumors of the sack around the spinal cord (5) herniation of the brain contents into the beginning of the spinal canal, especially in situations in which there is undiagnosed raised pressure within the brain (4) infection possibly around the lumbar puncture site or the spinal canal (3) minor back pain and occasional tingling and numbness in the buttock and legs (2) mild bleeding and hematoma formation (bruising) Such complications may include, in approximate descending order of occurrence: This is not common, but may be neccessary because some drugs do not easily pass from the blood to the cerebrospinal fluid.Ī lumbar puncture is extremely safe, and provided that unexpected raised pressure has been excluded by a CT or MRI scan, and that standard infection control measures and a good technique are adopted, the risk of complications is minimal. Sometimes a lumbar puncture will be undertaken not for diagnosis, but for treatment to introduce chemotherapy or antibiotics into the fluid around the brain. evidence that perhaps cancer from somewhere else in the body may have spread to the coverings of the brain (metastatic infiltration)Ī lumbar puncture is usually only undertaken after a CT or MRI of the brain is performed to rule out any tumour or swelling of the brain.if there is the suspicion of increased pressure in the brain for what ever reason.inflammation of the nerve roots as they leave the spinal cord, the most common cause of which is Guillain-Barré syndrome.a suspicion of a ruptured blood vessel in the brain (subarachnoid hemorrhage).The most common reasons for a lumbar puncture would be in aid in diagnosis of the following: Normally there should be no cells in the fluid, unless perhaps a small amount of blood was introduced during the procedure. The fluid is sent to a laboratory for analysis to look for any evidence of infection or inflammation or possibly other cells. Sometimes, to make it easier, the patient may be required to sit upright and lie forwards. The patient is often required to lie on his or her side with knees up into the stomach, in the"fetal position." The pressure of the fluid in the spinal cord is often measured. The reasons why a lumbar puncture is undertaken today are listed below, but because of much more sophisticated ways of veiwing the brain, with MRI scans especially, it is less often indicated in the diagnosis and management of neurologic illness than it was 100 plus years ago. The first known lumbar puncture was performed almost 120 years ago. The needle is similar, however in an epidural, anesthetic agent is introduced near the spinal cord, whereas in a lumbar puncture the hollow needle is inserted into the fluid sac surrounding the spinal cord and a sample, usually a teaspoon or two, is taken. The technique is very similar to the procedure of an epidural anesthesia given to women during childbirth. A lumbar puncture is usually performed in a hospital, but it only requires a brief stay of less than a day. The fluid (cerebrospinal fluid), which is crystal clear and looks like water, surrounds the brain and spinal cord to act as a protective agent as well as to supply nutrition and fight infection. A lumbar puncture is a medical procedure undertaken to remove and test fluid from the spinal cord.
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